持续高眼压状态下小梁切除术的临床疗效

Efficacy of trabeculectomy with persistent high intraocular pressure

目的探讨急性闭角型青光眼持续高眼压状态下行小梁切除术的临床疗效。方法对33例33眼眼压控制不良(大于30 mmHg)的急性闭角型青光眼患者进行小梁切除术,观察术后视力、眼压,术中、术后并发症。结果 1例术中出现爆发性脉络膜上腔出血,1例术后第2 d出现局部脉络膜浅脱离,经扩瞳、激素治疗后恢复,其他所有患者手术均顺利完成,未出现眼内出血、恶性青光眼等并发症。术后随访3～12个月,所有患者无需任何药物,眼压均控制在正常范围(8～17 mmHg)。术后视力提高31眼,视力不变1眼,视力下降1眼。结论对急性闭角型青光眼持续高眼压患者,为避免视功能进一步损害,应尽早行手术治疗,小梁切除术是安全有效的措施。

Objective To assess the efficacy of trabeculectomy for primary acute angle-closure glaueome （PACG） with persistent high intraoeular pressure（IOP）. Methods A retrospective analysis of post-operative visual acuity ,intraoeular pressure ,intra-operative and post- operative complications was performed after trabeculectomy in 33 eyes of 33 patients with PACG and whose IOP was more than 30 mmHg. Results Massive ehoroidal hemorrhage was observed in one patient （leye） during surgery. One patient（ 1 eye）encountered mild ehoroidal de- tachment in day 2 post-surgery. Completely cure was achieved after mydriasis and administration of cortieoid. All patients did not suffer other severe complications, such as intraocular hemorrhage and malignant glaucoma. Satisfactory IOP control in normal range 8-17 mmHg （lkpa=7.5 mmHg）was achieved in all patients without anti-glaucoma medications during 3-12 months of follow-up evaluation. The postoperative visual acuity improved in 31 eyes, remained unchanged in 1 eye, and decreased in 1 eye. Conclusion Trabeculectomy for primary acute angleclosure glaucoma with persistent high IOP is safe and effective. To prevent further damage to visual function, trabeeulectomy should be peribrmed for these patients as early as possible.